| Marisa Mills, LLP | |
|
25900 Greenfield Rd Ste 100, Oak Park, MI 48237-1297 | |
| (248) 788-4300 | |
| Not Available |
| Full Name | Marisa Mills |
|---|---|
| Gender | Female |
| Speciality | Psychologist |
| Location | 25900 Greenfield Rd Ste 100, Oak Park, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861102626 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 6362008888 (Michigan) | Primary |
| Entity Name | Life Skills Village Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629316815 PECOS PAC ID: 2860624103 Enrollment ID: O20140421000357 |
| Mailing Address | Practice Location Address |
|---|---|
| Marisa Mills, LLP 25900 Greenfield Rd Ste 100, Oak Park, MI 48237-1297 Ph: (248) 788-4300 | Marisa Mills, LLP 25900 Greenfield Rd Ste 100, Oak Park, MI 48237-1297 Ph: (248) 788-4300 |
Dr. Debora Ilene Rothbart, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 26031 Stratford Pl, Oak Park, MI 48237 Phone: 248-968-1162 Fax: 248-968-1162 | |
Destiny Peterson, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 25900 Greenfield Rd Ste 100, Oak Park, MI 48237 Phone: 248-788-4300 | |
Dr. Olga Mikhaylovna Slavin-spenny, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 25900 Greenfield Rd Ste 502, Oak Park, MI 48237 Phone: 248-849-0050 | |
Austin Peter Giacomantonio, MA TLLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 25900 Greenfield Rd Ste 100, Oak Park, MI 48237 Phone: 248-788-4300 | |
Michelle Maree Mcgarrity, MA LLP Psychologist Medicare: Medicare Enrolled Practice Location: 21951 Whitmore St, Oak Park, MI 48237 Phone: 248-514-2017 | |
Cammi Shoultz, DLLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 25900 Greenfield Rd Ste 100, Oak Park, MI 48237 Phone: 248-788-4300 Fax: 248-605-8099 |